Röntgen- und Laborbefunde bei der generalisierten Tendomyopathie

  • W. Brückle
Conference paper


Low-back pain is the most frequent and, usually, first symptom of fibromyalgia (FM). To decide if low-back pain in FM is caused by structural or static pathologic changes of the spine, we compared lumbar column x-rays of 47 female patients with x-rays of 45 age- and sex-matched controls. The x-rays of FM showed significantly more frequent static changes. Structural changes were also found more frequently in FM than in controls (especially osteochondrosis and pseudospondylolisthesis). Osteoarthritis, however, was seen in both collectives without any difference. The radiologically visible changes in lumbar spine could be one of many factors in the development of FM, although these findings are not of benefit for diagnosis and prognosis of this disease in the individual case. Most rheumatologists take pathological laboratory values for excluding FM. Nevertheless, it is assumed that thyroidal hormones, serotonin, and immunological parameters differ from healthy individuals. FM data from 98 patients were analyzed according to an extensive spectrum of laboratory parameters, and compared with the literature. Except for hyaluronic acid, only a few values were (often borderline) pathological. Summarizing pathological laboratory values plus diagnosis, FM has to be followed by differential diagnostic considerations. At present, there is no test which can confirm the diagnosis of FM.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bengtsson A, Henriksson KG, Jorfeldt L et al. (1986) Primary fibromyalgia. A clinical and laboratory study of 55 patients. Scand J Rheumatol 15: 340–347PubMedCrossRefGoogle Scholar
  2. 2.
    Bennett RM, Gatter RA, Campbell SM, Andrews RP, Clark SR, Scarola JA (1988) A comparison of cyclobenzaprine and placebo in the management of fibrositis. A double-blind controlled study. Arthritis Rheum 31: 1535–1542PubMedCrossRefGoogle Scholar
  3. 3.
    Brückle W, Müller W (1988) Inzidenz von pathologischen Computertomographiebefunden der LWS bei Patienten mit GTM. Z Rheumatol 47: 279–280Google Scholar
  4. 4.
    Brückle W et al. (1991) Die Laborbefunde bei der generalisierten Tendomyopathie. In VorbereitungGoogle Scholar
  5. 5.
    Burda CD (1984) Immunglobulin-G deposits at the dermal-epidermal junction in secundary (traumatic) fibromyalgia. Clin Exp Rheumatol 2: 195PubMedGoogle Scholar
  6. 6.
    Burda CD, Fox FR, Osborne P (1986) Histocompatibility antigens in the fibrositis (fibromyalgia) syndrome. Clin Exp Rheumatol 4: 355–357PubMedGoogle Scholar
  7. 7.
    Caro XJ (1984) Immunofluorescent detection of IgG at the dermal-epidermal junction in patients with apparent primary fibrositis syndrome. Arthritis Rheum 27: 1174–1179PubMedCrossRefGoogle Scholar
  8. 8.
    Caro XJ, Quismorio FP jr (1985) Immunological studies of skin and circulating autoantibodies in primary fibrositis syndrome (abstr). Arthritis Rheum 28: 98CrossRefGoogle Scholar
  9. 9.
    Caro XJ, Ramadas K, Heiner DC et al. (1985) Serum total IgE and IgG4 levels in primary fibrositis syndrome. Presented to the Study Group Session on Nonarticular Rheumatism, 49th Annual Meeting, American Rheumatism Association. Anaheim, June 1985Google Scholar
  10. 10.
    Caro XJ, Wolfe F, Johnston WH, Smith AL (1986) A controlled and blinded study of immunoreactant deposition at the dermal-epidermal junction of patients with primary fibrositis syndrome. J Rheumatol 13: 1086–1092PubMedGoogle Scholar
  11. 11.
    Dinerman H, Goldenberg DL, Felson DT (1986) A prospective evaluation of 118 patients with the fibromyalgia syndrome: Prevalence of Raynaud’s phenomenon, Sicca symptoms, ANA, Low complement, and Ig Deposition at the Dermal-Epidermal Junction. J Rheumatol 13: 368–373PubMedGoogle Scholar
  12. 12.
    Eneström S, Bengtsson A, Lindström F, Johan K (1990) Attachement of IgG to dermal extracellular matrix in patients with fibromyalgia. Clin Exp Rheumatol 8: 127–135PubMedCrossRefGoogle Scholar
  13. 13.
    Forre O, Vaeroy H, Kass E (1987) Possible subgroups of the fibromyalgia syndrome. Scand J Rheumatol (Suppl) 69: 12Google Scholar
  14. 14.
    Gallati M (1990) Radiologische Veränderungen bei generalisierter Tendomyopathie. Inauguraldissertation, BaselGoogle Scholar
  15. 15.
    Hall S, Littlejohn GO, Jethwa J et al. (1983) Plasma beta-endorphin levels in fibrositis (abstr). Arthritis Rheum 26: 539Google Scholar
  16. 16.
    Hamaty D, Valentine JL, Howard R et al. (1989) The plasma endorphin, prostaglandin and catecholamine profile of patients with fibrositis treated with cyclobenzaprine and placebo: A 5-month study. J Rheumatol 16: 164–168Google Scholar
  17. 17.
    Horal J (1969) Acta orthopaedica scandinavica. The clinical appearence of low back disorders in the city of Gothenburg, Sweden (Suppl 118 )Google Scholar
  18. 18.
    Koenig WC jr, Powers JJ, Johnson EW (1977) Does allergy play a role in fibrositis? Arch Phys Med Rehabil 58: 80PubMedGoogle Scholar
  19. 19.
    Kogstad O (1988) Primary fibromyalgia syndrome — subgroups of inflammatory rheumatic nature? Scand J Rheumatol 17: 154PubMedCrossRefGoogle Scholar
  20. 20.
    Lautenschläger J, Brückle W, Seglias J, Müller W (1989) Lokalisierte Druckschmerzen in der Diagnose der generalisierten Tendomyopathie ( Fibromyalgie ). Z Rheumatol 48: 132–138PubMedGoogle Scholar
  21. 21.
    McBroom P, Kolb WP, Kolb LM et al. (1984) Cutaneous vascular immunofluorescence in patients with fibromyalgia syndrome: Correlation with circulating immune complexes. Presented to the Study Group Session on Nonarticular Rheumatism, 48th Annual Meeting. American Rheumatism Association. Minneapolis, June 1984Google Scholar
  22. 22.
    McCain GA, Tilbe KS (1989) Diurnal hormone variation in fibromyalgia syndrome: a comparison with rheumatoid arthritis. J Rheumatol (Suppl 19 ) 16: 154–157Google Scholar
  23. 23.
    Meske-Brand S, Kapp A, Müller W (1984) Die generalisierte Tendomyopathie, ein Syndrom im Rahmen der Atopie? Aktuel Rheumatol 9: 156–158CrossRefGoogle Scholar
  24. 24.
    Moldofsky H, Warsh JJ (1978) Plasma tryptophan and musculoskeletal pain in non-articular rheumatism (“fibrositis syndrome”). Pain 5: 65–71PubMedCrossRefGoogle Scholar
  25. 25.
    Müller W, Perini C, Battegay R, Labhardt F (1981) Die generalisierte Tendomyopathie ( Fibrositissyndrom ). Internist Welt 7: 268Google Scholar
  26. 26.
    Müller W (1987) The Fibrositis Syndrome: Diagnosis, Differential Diagnosis and Pathogenesis. Scand J Rheumatol (Suppl) 65: 40–53CrossRefGoogle Scholar
  27. 27.
    Peter JB, Wallace DJ (1988) Abnormal immune regulation in fibromyalgia (abstr). Arthritis Rheum 31: S24Google Scholar
  28. 28.
    Russell IJ, Wolfe F, Burda C et al. Histocompatibility (HLA) in primary fibrositis (fibromyalgia) syndrome. Presented to the Study Group Session on Nonarticular Rheumatism, 50th Annual Meeting American Rheumatism Association. New Orleans, June 1986Google Scholar
  29. 29.
    Russell I J, Vipraio GA, Michalek J, Fletcher E (1988) Abnormal T cell subpopulations in fibrositis syndrome (abstr). Arthritis Rheum 31: 99CrossRefGoogle Scholar
  30. 30.
    Russell I J, Michalek JE, Vipraio GA, Fletcher EM (1989) Serum amino acids in fibrositis/ fibromyalgia syndrome. J Rheumatol 16: 158–163Google Scholar
  31. 31.
    Seibel MJ, Raimann S, Lautenschläger J, Müller W (1988) Serum-Hyaluronsäure und aminoterminales Prokollagen-III-Peptid bei entzündlichen und degenerativen Erkrankungen. Z Rheumatol 47: 98–106PubMedGoogle Scholar
  32. 32.
    Seibel MJ (1989) Komponenten der extrazellulären Gewebematrix als potentielle Marker des Bindegewebs-, Knorpel- und Knochenmetabolismus bei Erkrankungen des Bewegungsapparates. Z Rheumatol 48: 6–18PubMedGoogle Scholar
  33. 33.
    Smythe HA (1985) Non-articular rheumatism and psychogenic musculoskeletal syndromes. In: McCarthy DJ (ed) Arthritis and Allied Conditions. Lea & Febiger, Philadelphia, p 1083Google Scholar
  34. 34.
    Vaeröy H, Sakurada T, Forre O et al. (1989) Modulation of pain in fibromyalgia (fibrositis syndrome): Cerebrospinal fluid (CSF) investigation of pain related neuropeptides with special reference to calcitonin gene related peptide ( CGRP ). J Rheumatol 16: 94–97Google Scholar
  35. 35.
    Willis TA, Runge C (1924) The lumbosacral vertebral column in man. Am J Anat 32: 95CrossRefGoogle Scholar
  36. 36.
    Wyttenbach A (1987) Das klinische Bild der generalisierten Tendomyopathie. Dissertation, BaselGoogle Scholar
  37. 37.
    Yunus MB, Masi AT, Calabro JJ, Miller KA, Feigenbaum SC (1981) Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. Sem Arthr Rheumatol 11: 151–171CrossRefGoogle Scholar
  38. 38.
    Yunus MB, Masi AT (1984) Antinuclear antibodies (ANA) in primary fibromylagia syndrome. Presented to the Study Group Session on Nonarticular Rheumatism, 48th Annual Meeting of the American Rheumatism Association. Minneapolis, June 1984Google Scholar
  39. 39.
    Yunus MB, Denko CW, Masi AT (1986) Serum-endorphin in primary fibromyalgia syndrome: A controlled study. J Rheumatol 13: 183–186PubMedGoogle Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt 1991

Authors and Affiliations

  • W. Brückle
    • 1
    • 2
  1. 1.Rheumatologische UniversitätsklinikBaselSwitzerland
  2. 2.RheumaklinikBad NenndorfDeutschland

Personalised recommendations